Feline Hepatic Lipidosis in the Obese Cat

Feline Hepatic Lipidosis
in the Obese Cat

By Dr. Ed Mapes
Stonebridge Animal Hospital
McKinney, Tx.

A recent series of articles addressing obesity identified a number of diseases that plague overweight animals. Of these, feline hepatic lipidosis (FHL) may be the most insidious and certainly one of the deadliest. FHL, also known as “fatty liver disease”, can occur on its own or in conjunction with a variety of other medical problems, but the bottom line is that the cat breaks down body fat and protein in order to supply energy needs. This process causes excessive fat accumulation in liver cells that inhibits normal organ function – this is feline hepatic lipidosis.

Stress has more profound effects on cats than many other species, and can result from situations such as alterations in diet, environmental changes, or a concurrent disease (diabetes mellitus, hyperthyroidism, heart disease, kidney disease, and cancer). The result of this systemic stress is a reduction in appetite, and the body responds by breaking down fat and muscle protein to supply energy.

Patients are typically older cats that have been obese and undergone stress and a loss of appetite for extended periods of time – often incurring significant weight loss during the process. They’re depressed, refuse food and have lost fat and muscle mass. They may experience vomiting, loose stools, become dehydrated and pale or jaundiced.

The physical examination and history are usually enough to point the diagnosis toward FHL and possibly a concurrent disease. Blood is then drawn for testing, and often reveals liver abnormalities, high levels of bilirubin, elevated cholesterol, possibly some degree of anemia and even clotting abnormalities. A bile acids test usually reveals abnormal liver function as well.

X-rays and ultrasound can provide additional clues, but the best diagnostic test is a liver biopsy – obtaining cells by inserting a needle into the liver or by taking a larger sample with a quick surgical procedure.

Early diagnosis of FHL can be essential to survival. The key to treatment is in providing food high in calories and protein to stop the breakdown of body cells. Feeding tubes are sometimes necessary, since patients refuse to eat and force-feeding can be overly stressful. I often install tubes through the side of the neck into the esophagus –pharyngostomy tubes – into which slurries of food is provided.

Intravenous catheters are often installed in very sick patients as ports for fluid therapy, electrolytes, potassium, antibiotics, and other medications. Medications can include vitamin supplements (B complex and K especially), stomach protectants, intestinal antibiotics, and anti-emetics. Getting past the first 48 hours can often be crucial; prognosis often improves if we get past that time in treatment. A corner is turned when the cat begins eating on its own, but medications can continue for months, and measures such as controlling other disorders, reducing stressors, and specialized diets are often necessary on a maintenance basis.

The decreased appetite and weight loss can occur gradually, and can be difficult to recognize. Any cat, especially those that are overweight, fitting this description should be examined by a veterinarian since treatment becomes more difficult as the disease progresses.

Comments are closed.